Senate Bill sb1938c1
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Florida Senate - 2007 CS for SB 1938
By the Committee on Health Regulation; and Senator Joyner
588-2156-07
1 A bill to be entitled
2 An act relating to cardiology services;
3 providing legislative findings and intent;
4 providing definitions; requiring the Department
5 of Health to post and update a list of
6 percutaneous intervention centers and
7 open-heart surgery programs on its website;
8 requiring the department to send a list of such
9 centers and programs to emergency medical
10 services providers and emergency medical
11 services directors in the state; directing the
12 department to develop and distribute sample
13 cardiac triage assessment criteria; requiring
14 licensed emergency medical services providers
15 to use similar assessment criteria; requiring
16 the director of each emergency medical services
17 provider to develop and use certain specified
18 protocols; providing duties of the department;
19 requiring a report; providing for meetings;
20 requiring compliance by a certain date;
21 providing an effective date.
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23 WHEREAS, every year, approximately 24,000 people in
24 this state suffer a life-threatening heart attack, one-third
25 of whom die within 24 hours after the attack, and
26 WHEREAS, fewer than 20 percent of heart attack victims
27 receive emergency angioplasty to open blocked arteries, and
28 WHEREAS, studies have shown that individuals suffering
29 a life-threatening heart attack have better outcomes if they
30 receive emergency angioplasty, and
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Florida Senate - 2007 CS for SB 1938
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1 WHEREAS, studies have shown that opening a blocked
2 coronary artery with emergency angioplasty within recommended
3 timeframes can effectively prevent or significantly minimize
4 permanent damage to the heart, and
5 WHEREAS, even fewer patients receive the procedure
6 within the timeframe recommended by the American Heart
7 Association, and
8 WHEREAS, damage to the heart muscle can result in
9 death, congestive heart failure, atrial fibrillation, and
10 other chronic diseases of the heart, and
11 WHEREAS, organizations such as the American Heart
12 Association, the American College of Cardiology, and the
13 Florida College of Emergency Physicians recommend deploying
14 protocols and systems to help ensure that people suffering
15 from a life-threatening heart attack receive the latest
16 evidence-based care, such as emergency angioplasty, within
17 recommended timeframes, and
18 WHEREAS, Florida's trauma services system and emergency
19 stroke treatment system have dramatically improved the care
20 provided for individuals suffering from a traumatic injury or
21 a stroke, and
22 WHEREAS, a statewide emergency cardiac system can help
23 ensure that people suffering from a life-threatening heart
24 attack will receive the latest evidence-based care within
25 recommended timeframes, NOW, THEREFORE,
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27 Be It Enacted by the Legislature of the State of Florida:
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29 Section 1. Emergency medical services providers;
30 triage and transportation of ST elevation myocardial
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Florida Senate - 2007 CS for SB 1938
588-2156-07
1 infarction victims to a percutaneous intervention center or an
2 open-heart surgery program; definitions.--
3 (1)(a) The Legislature finds that rapid identification
4 and treatment of serious heart attacks known as ST elevation
5 myocardial infarction according to the latest evidence-based
6 standards can significantly improve outcomes by reducing death
7 and disability by rapidly restoring blood flow to the heart.
8 (b) The Legislature further finds that a strong
9 emergency system to support survival from life-threatening
10 heart attacks is needed in our communities in order to treat
11 victims in a timely manner and to improve the overall care of
12 heart attack victims.
13 (c) Therefore, the Legislature intends to establish a
14 statewide emergency cardiac system to help improve outcomes
15 for individuals suffering from a life-threatening heart
16 attack.
17 (2) As used in this section, the term:
18 (a) "Agency" means the Agency for Health Care
19 Administration.
20 (b) "Department" means the Department of Health.
21 (c) "Open-heart surgery program" means an open-heart
22 surgery program licensed by the agency under s. 408.0361(3),
23 Florida Statutes.
24 (d) "Percutaneous intervention center" means a
25 provider of adult interventional cardiology services licensed
26 by the agency under s. 408.0361, Florida Statutes.
27 (3) By December 1, 2007, and by June 1 of each year
28 thereafter the agency shall post on its website a list of the
29 percutaneous intervention centers and the open-heart surgery
30 programs that are licensed by the agency.
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Florida Senate - 2007 CS for SB 1938
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1 (4) By June 1, 2008, or 6 months after the agency
2 adopts a rule governing certification of percutaneous
3 intervention centers under s. 408.036(3)(o), Florida Statutes,
4 whichever is later, and by June 1 of each year thereafter, the
5 department shall send a list of the names and addresses of
6 each percutaneous intervention center and open-heart surgery
7 program that is licensed by the agency to each licensed
8 emergency medical services provider and emergency medical
9 services director in the state.
10 (5) The department shall develop sample cardiac triage
11 assessment criteria. The department must post this sample
12 assessment criteria on its website and provide a copy of the
13 assessment criteria to each licensed emergency medical
14 services provider and emergency medical services director no
15 later than December 1, 2008. Each licensed medical services
16 provider must use cardiac triage assessment criteria that are
17 substantially similar to the sample cardiac triage assessment
18 criteria provided by the department under this subsection.
19 (6) The medical director of each licensed emergency
20 medical services provider shall develop and implement
21 assessment, treatment, and transportation protocols for
22 cardiac patients and employ those protocols to assess, treat,
23 and transport ST elevation myocardial infarction patients to
24 the most appropriate hospital. Such protocols may include use
25 of a community plan to address transport of cardiac patients
26 to appropriate facilities in a manner that addresses
27 community-specific resources and needs.
28 (7) The department shall develop and provide technical
29 support, equipment recommendations, and necessary training for
30 effective identification of acute ST elevation myocardial
31 infarction patients to each licensed emergency medical
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Florida Senate - 2007 CS for SB 1938
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1 services provider and emergency medical services director. The
2 department shall model the sample cardiac triage assessment
3 criteria on the American Heart Association's advanced
4 cardiovascular life support chest pain algorithm for
5 prehospital assessment, triage, and treatment of patients with
6 suspected ST elevation myocardial infarction or a
7 substantially similar program or a program with evidence-based
8 guidelines. The department shall conduct a biennial survey of
9 all applicable licensed emergency medical services providers
10 to develop an inventory of their equipment and identify their
11 equipment needs, their training requirements, and their
12 performance regarding the practical application of protocols
13 and the identification of acute ST elevation myocardial
14 infarction in the field. The department shall report its
15 survey findings and provide a copy of the survey to emergency
16 medical services providers, emergency medical services
17 directors, the Emergency Medical Services Advisory Council,
18 and other stakeholders.
19 (8) The department is encouraged to identify and
20 provide opportunities, partnerships, and resources to secure
21 appropriate equipment for identification of ST elevation
22 myocardial infarction in the field to all licensed emergency
23 medical service providers.
24 (9) After implementation of the assessment criteria,
25 the department shall convene stakeholders at least once a
26 year, if necessary, to facilitate the sharing of experiences
27 and best practices. The best practices shall be made available
28 on the department's website.
29 (10) Each emergency medical services provider licensed
30 under chapter 401, Florida Statutes, must comply with this
31 section by July 1, 2009, or 6 months after the date it
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Florida Senate - 2007 CS for SB 1938
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1 receives the list of percutaneous intervention centers sent
2 pursuant to subsection (4), whichever is later.
3 Section 2. This act shall take effect July 1, 2007.
4
5 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
6 Senate Bill 1938
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8 The committee substitute adds definitions for open-heart
surgery program and percutaneus intervention center. The
9 committee substitute directs the Agency for Health Care
Administration (AHCA or agency) to post on its website a list
10 of the percutaneous intervention centers and open-heart
surgery programs. The committee substitute requires the
11 Department of Health (DOH or department) to develop sample
cardiac triage assessment criteria and post them on the DOH
12 website. Each Emergency Medical Services (EMS) provider must
use substantially similar assessment criteria. The committee
13 substitute requires EMS providers to comply with the specified
mandates by July 1, 2009.
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